Comparative Study of Placenta Accreta Diagnosis by Ultrasound (2D and 3D) Versus Maternal Alpha-Fetoprotein in Women with Previous Cesarean Sections
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- Category: Vol. 81, December 2013
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Comparative Study of Placenta Accreta Diagnosis by Ultrasound (2D and 3D) Versus Maternal Alpha-Fetoprotein in Women with Previous Cesarean Sections, HANY M.A. EL DIDY, AHMED H. AL SAWAF, MAHA A. RASHID and MOHAMED OSAMA
Abstract
Objective: To compare the efficiency of diagnosis of placenta accreta by grayscale ultrasound and 3D power Doppler versus maternal level of serum alpha-fetoprotein in women with previous cesarean sections.
Patients and Methods: A total of 60 patients were chosen from those admitted for elective cesarean sections at Kasr Al Aini, Obstetrics and Gynecology Hospital in the late third trimester (36 weeks or more) from June 2012 to June 2013. Patients were divided into 2 groups; case group with placenta previa and control group with upper segment implanted placenta. Each group was subjected to ultrasound examination by greyscale ultrasound and 3D power Doppler. Maternal serum level of alpha-fetoprotein was estimated and the con-dition of placenta was determined by the surgeon intra-operatively.
Results: Placenta accreta and its variants (including increta and percreta) were confirmed in 18 patients at the time of Cesarean delivery. Diagnosis by greyscale ultrasound, 3D power Doppler and MS-AFP was compared and it was found that found MS-AFP was the most sensitive with 88.9% sensi-tivity, followed by greyscale ultrasound with 77.8% sensitivity followed by 3D power Doppler with 66.7% sensitivity. How-ever MS-AFP was the least specific with specificity of 33.3% followed by greyscale ultrasound with 66.7% specificity and the most specific was 3D power Doppler with 83.3% speci-ficity.
Conclusion: MS-AFP may be useful as a complimentary technique with ultrasound (2D and 3D) for the antenatal diagnosis of placenta accreta. It could be also used as a screening test for diagnosis of placenta accreta.